Provider Demographics
NPI:1851034631
Name:MULIRO, MONICA NASAMBU (LSWAIC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:NASAMBU
Last Name:MULIRO
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16511 CARLYLE HALL RD N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-5224
Mailing Address - Country:US
Mailing Address - Phone:206-946-0359
Mailing Address - Fax:
Practice Address - Street 1:11416 SLATER AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8827
Practice Address - Country:US
Practice Address - Phone:425-333-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC611961771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty